Provider Demographics
NPI:1801331939
Name:DAVALL, ALISHA (RRT)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:DAVALL
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 SUNNY ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-6410
Mailing Address - Country:US
Mailing Address - Phone:828-442-5602
Mailing Address - Fax:
Practice Address - Street 1:42 SUNNY ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-6410
Practice Address - Country:US
Practice Address - Phone:828-442-5602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC49062279E0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279E0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEmergency Care